Young adult reconsiders hip replacement surgery

I’m a 42-year old active male with serious hip pain. When I was 36, I saw a surgeon who told me I’m too young for a hip replacement. Has anything changed in the last six years? I’m still suffering and would really like to remain active.

Improved diagnostic imaging may be what has changed the most. The use of thin-cut CT scans gives a 3-D view of the hip joint. Combined with magnetic resonance arthrography (MRA) and X-ray, surgeons can better see what is the problem. Understanding the cause of painful symptoms helps the surgeon plan a more effective treatment.

By the way, MRA is the injection of a contrast agent (dye) directly into the joint space. Then MRI pictures are taken. The technique helps show the shape and depth of the joint space. The dye will seep into any areas where the cartilage is torn or pulled away.

There are two main reasons why young adults have hip pain. Abnormal loading and pinching called impingement can result in pain and loss of motion. A shallow hip socket called dysplasia can do the same thing. In many cases, the surgeon may be able to repair and realign the hip.

It may be time to go back for a second look or a second opinion about your particular situation. New advances in the diagnosis and treatment of hip pain in young adults may put a different spin on your case.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

MRI or MRA to diagnose rotator cuff tear?

I’m going to be seeing the doctor for a shoulder exam. I’m pretty sure I have a torn rotator cuff. Should I ask for an MRI?

Your surgeon will know the best tests to order based on your history and the examination. MRIs give good contrast of the soft tissues. It’s an ideal way to see inside the joint without actually opening it up.

MRIs are only 84 to 96 percent accurate in finding rotator cuff tears (RCT). Magnetic Resonance Arthrography (MRA) may be a better choice if a RCT is suspected.

MRA uses the natural fluid in the joint as a way to look for “holes” in the capsule from a RCT. A contrasting agent is injected into the joint. Any fluid that shows up outside the capsule must have moved through the defect.

MRA isn’t available everywhere. Ask your surgeon if it’s available in your area and if it’s recommended for your situation.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Doctor exam as good as MRI in diagnosing ACL injury?

My 17-year old son tore his ACL playing soccer. The doctor told us it was torn before the MRI confirmed it. Why did we need the expensive MRI test if the doctor already knew what was wrong?

Magnetic resonance imaging (MRI) has become the standard test for knee injuries. But you’re right about the expense. One study stated that MRI is equal in cost to a doctor’s exam only if the cost of the MRI is less than $250.00. MRIs can cost much more than that.

The pendulum is now swinging back the other way. Studies show a doctor’s exam is just as good as an MRI . . . most of the time. This assumes the doctor is well-trained in evaluating knee injuries.

An MRI does offer some information to help the doctor direct treatment. The MRI can show where the cartilage (meniscus) or ligament (ACL) is torn and how large the tear is. This helps in deciding between rehab and surgery. This information can be very helpful with elite athletes trying to get back on the field.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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MRA or arthroscopy needed to diagnose hip pain

How can I find out what’s wrong with my hip? I’ve had an X-ray and an MRI. Both were “normal”. But I can tell you that hip is not “normal”. I have pain and can’t bend it all the way or turn it in. Sometimes I have trouble turning my hip out, too. Where do I go from here?

If you’ve had some imaging studies it sounds like a physician has started the diagnostic process. The next step is to go back to the doctor. You may need an MRA or magnetic resonance arthrography. A liquid dye is injected into the joint space. This allows the radiologist to see the outlines of the joint capsule that don’t show up otherwise.

One other step is to look inside the joint with an arthroscope. A long, thin needle is inserted into the joint. A tiny TV camera on the end of the tool allows the physician to view the joint.

This doesn’t always work without manipulating the joint first. Manipulation is done while the patient is sedated. The doctor moves the joint through its full range of motion. Some pressure may be needed to break loose any adhesions or bits of scar tissue holding the joint back.

Ask your doctor what your options are given your symptoms, history, and results of early imaging studies.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

MRA more accurate than MRI for ddetermining cause of hip pain

What is magnetic resonance arthrography (MRA)? I’ve heard of MRI but not MRA. My doctor wants me to have an MRA to help figure out what’s wrong with my hip.

Magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) are very similar tools. MRA is basically MRI for the joints. It is more accurate in detecting joint problems. MRI can confirm there’s a problem in the joint. MRA shows exactly what is the abnormality.

CT scans work well for bone lesions around the hip. CT scan shows places where the bone might have a tumor, abnormal anatomy, or necrosis (dead cells).

If you ever need surgery on the hip, advanced imaging studies of this type are very important. The more details the surgeon can see ahead of time, the better the surgical plan with no (or very few) last minute surprises.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.